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A punctal plug, also known as tear duct plug or lacrimal plug, is a small medical device that is inserted into the tear duct (puncta) of an eye to block the duct. This prevents the drainage of liquid from the eye. They are used to treat dry eye. Artificial tears are usually still required after punctal plug insertion. [1]
A punctal plug may be inserted into the tear duct by an optometrist or ophthalmologist, decreasing the removal of natural tears from the affected eye. [8] The use of contact lenses may help prevent the abrasion during blinking lifting off the surface layer and uses thin lenses that are gas permeable to minimise reduced oxygenation.
It is not clear if punctal plugs are effective at reducing dry eye syndrome symptoms. [60] Punctal plugs are thought to be "relatively safe", however, their use may result in epiphora (watery eyes), and more rarely, serious infection and swelling of the tear sac where the tears drain. [ 60 ]
Causes of epiphora are any that cause either overproduction of tears or decreased drainage of tears, resulting in tearing onto the cheek. [2] This can be due to ocular irritation and inflammation (including trichiasis and entropion) or an obstructed tear outflow tract, which is divided according to its anatomical location (i.e., ectropion, punctal, canalicular or nasolacrimal duct obstruction).
Persons with dry eye conditions can be fitted with punctal plugs that seal the ducts to limit the amount of fluid drainage and retain moisture. During an ear infection, excess mucus may drain through the nasolacrimal duct in the opposite way tears drain. [citation needed] In humans, the tear ducts in males tend to be larger than the ones in ...
Nettleship's punctum dilator: to dilate the lacrimal punctum of the lacrimal apparatus of the eye for syringing or operations Cystotome: a 26 gauge needle bent twice used for incising the anterior capsule of the lens in lens extraction Wire vectis: a loop of wire attached to a stack used to extract cataract affected lenses Irrigating vectis
Some patients with more severe problems use goggles to increase local humidity or have punctal plugs inserted to help retain tears on the ocular surface for a longer time. [78] Additionally, cyclosporine (Restasis) is available by prescription to treat chronic dry eye by suppressing the inflammation that disrupts tear secretion.
Tears are produced by the lacrimal gland, situated just outside the eye. Blinking the eyelids distributes the tears to keep the eyes moist, clean and lubricated. Excess tears are drained via the punctum through the tiny channels called canaliculi located on the inner side of the eyes into the tear sac, from there to the tear duct, the nose and finally down the throat.